ABSTRACT
Objective To increase curative rate of nonoperation treatment for adult blunt splenic trauma.Methods Data of 141 patients with blunt splenic trauma treated in our hospital from March 2010 to October 2014 were retrospectively analyzed in accordance with the spleen injury degree classification issued by the Spleen Surgery Group of Chinese Society of Surgery in 2000.According to the treatment within 6 hours of injury,these patients were divided into operative and nonoperative management groups.Results The proportion of non operation was 69.5％ (98/141) and the success rate was 89.8％ (88/98).43 cases were in operation group:34 cases in grade Ⅲ,9 cases with grade Ⅳ,3 cases died; 98 cases were in non operation group:including 32 cases of grade Ⅰ,50 cases of grade Ⅱ,15 cases of grade llⅢ,1 case with grade Ⅳ.10 cases failed non operation treatment including 1 case with grade Ⅰ complicated by pancreatic and intestinal injury causing peritonitis during the period of observation,1 case of grade Ⅱ complicated by contusion of the liver and secondary bleeding on day 3 after the trauma,7 cases of grade Ⅲ,were converted to surgery because of multiple organ injury and rebleeding secondary to pulmonary complications,and 1 case of grade Ⅳ with multiple organ injury and shock being immediately converted to surgery.In overall there were 2 deaths in nonsurgery group,1 case with grade Ⅲ and 1 case with grade Ⅳ.Condusions Nonoperative treatment of blunt splenic trauma is safe and feasible in grade up to]Ⅱ blund splenic trauma patients.
ABSTRACT
Objective To clarify the etiology of pathological nipple discharge.Methods Since 1990,81 patients with pathological niplpie discharge underwent mammary duct incision to identify the lesion.Results 67 patients had intraductal papilloma,5 patients had intraductal papillomatosis,6 patients had duct carcinoma,and 3 patients were not found pathological changes.Conclusions Intraductal papilloma,intraductal papillomatosis,and duct carcinoma might be the exclusive etiology of pathological nipple discharge.
ABSTRACT
Objective To investigate the feasibility of transcystic removal of common bile duct stones during laparoscopic cholecystectomy. Methods Clinical data of 18 cases of transcystic cholangiography during laparoscopic cholecystectomy from January 2003 to July 2004 were retrospectively reviewed. Before the resection of the gallbladder, the cystic duct was opened to insert a catheter for cholangiography. After the common bile duct stones were detected, a wire basket was introduced transcystically to remove the stones. Results Transcystic cholangiography was conducted in 18 cases, 11 of which were detected as having common bile duct stones. Of the 11 cases, laparoscopic transcystic common bile duct exploration was successfully completed in 6 cases and failed in 2 cases with stones significantly larger than the diameter of the bile duct, 2 cases of failure of transcystic insertion of catheter, and 1 case with stones embedded in the hepatopancreatic ampulla. Follow-up with B-ultrasonography for 6~18 months in the 6 cases revealed no residual stones,biliary stricture,or bile duct dilatation. Conclusions Laparoscopic transcystic common bile duct exploration (LTCBDE) provides an effective option for the diagnosis and treatment of secondary common bile duct stones during laparoscopic cholecystectomy without opening the common bile duct.